EAGLEHOME1 NPI 1821118670

NPI Information

  • NPI: 1821118670
  • Provider Name: EAGLEHOME1
  • Classification: Custodial Care Facility - 311ZA0620X
  • Specialization: Adult Care Home
  • Entity Type: Organization
  • Address: 804 W GANNON AVE
    ZEBULON, NC
    ZIP 27597
  • Phone: (919) 269-9173

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NPI Details

EAGLEHOME1 is an adult care home custodial care facility in Zebulon, NC. The provider is a custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. EAGLEHOME1 NPI is 1821118670. The provider is registered as an organization entity type.

The provider's business location address is:

804 W GANNON AVE
ZEBULON, NC
ZIP 27597-516
Phone: (919) 269-9173
Fax: (919) 269-9173

The provider's authorized official is Rosemary Nwankwo .
The authorized official title is Administration and has the following contact phone number (919) 269-9173.

The enumeration date for this NPI number is 3/29/2007 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1311ZA0620XCustodial Care FacilityAdult Care HomeYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
17803989MEDICAIDNORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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